<style type="text/css">
.style1 {
	padding: 1em;
	margin: 1em;
}
.style2 {
	text-align: right;
	width: 98px;
	font-weight: bold;
}
.style3 {
	text-align: left;
	font-style: italic;
}
</style>
<table style="width: 400px" align="left" class="style1">
	<tr>
		<td class="style2" >Name:</td>
		<td class="style3"><?php echo $this->info['agent_name']; ?></td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
	</tr>
	<tr>
		<td class="style2">Address:</td>
		<td class="style3"><?php echo $this->info['address']; ?></td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
	</tr>
	<tr>
		<td class="style2">Mobile:</td>
		<td class="style3"><?php echo $this->info['mobile_no']; ?></td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
	</tr>
	<tr>
		<td class="style2">Landline:</td>
		<td class="style3"><?php echo $this->info['landline_no']; ?></td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
	</tr>
	<tr>
		<td class="style2">Occupation:</td>
		<td class="style3"><?php echo $this->info['occupation']; ?></td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
	</tr>
	<tr>
		<td class="style2">Date of Birth:</td>
		<td class="style3"><?php echo $this->info['dob']; ?></td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
	</tr>
</table>
